Inspection on 27/10/05 for 44 Monks Close

This inspection was carried out on 27th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

44 Monks Close 27/03/09

44 Monks Close 06/12/07

44 Monks Close 31/01/07

44 Monks Close 28/04/06

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 44 Monks Close Bircham Newton Norfolk PE31 6RD Lead Inspector Lella Andrews Announced 27th October 2005, 14:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 44 Monks Close I55 s62976 44 Monks Close v243514 AN 271005(4).doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 44 Monks Close Address Bircham Newton, Norfolk, PE31 6RD Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Yvonne Asbury n/a Care Home 1 Category(ies) of Learning Disability (1) registration, with number of places 44 Monks Close I55 s62976 44 Monks Close v243514 AN 271005(4).doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The Home is registered for one person with a learning disability who is named in the Commissions records Date of last inspection n/a Brief Description of the Service: Yvonne Asbury provices care and accommodation to an adult with a learning disability who has lived with the family for over fifteen years. It is likely that the service would be eligible to be registered as part of an Adult Placement Scheme but Norfolk does not have such a scheme and so the service is registered as a Care Home. 44 Monks Close I55 s62976 44 Monks Close v243514 AN 271005(4).doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Inspection was announced and took place between 2pm and 3.45pm on Thursday 27th October 2005. The Inspector spoke to the Proprietor and to the client. It would be more suitable for this service to be part of an Adult Placement Scheme but as there is no scheme available in Norfolk it must be registered as a Care Home and inspected against the regulations and national minimum standards. The Inspection has focused on the outcomes for the client living at the home and the report reflects this. The requirements and recommendations made are those which the Inspector feels are most relevant and appropriate for this service. What the service does well: What has improved since the last inspection? What they could do better: Currently the Proprietor is not keeping any written records relating to the care provided and there is a need to ensure that records are kept relating to the health and social needs of the service user, medication and financial matters. There is a need for the Proprietor to undertake some training, in particular, food hygiene, first aid and the protection of vulnerable adults. 44 Monks Close I55 s62976 44 Monks Close v243514 AN 271005(4).doc Version 1.40 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 44 Monks Close I55 s62976 44 Monks Close v243514 AN 271005(4).doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 44 Monks Close I55 s62976 44 Monks Close v243514 AN 271005(4).doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 The service is only registered for one named service user and so there is no need for the Proprietor to have an assessment process in place. EVIDENCE: The Proprietor has no intentions of providing a service to any other service users and is only registered to provide care and accommodation for the one service user who is living at the home. 44 Monks Close I55 s62976 44 Monks Close v243514 AN 271005(4).doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8 and 9 The service user does not have a care plan but as the Proprietor, and occasionally, her daughter are the only ones to provide care to the service user this does not cause obvious difficulties. There are no recorded risk assessments but the Proprietor knows the service user well and considers all risks before making any decisions affecting the service user. The service user lives as part of the family and, as such, is involved in discussions about issues that affect the running of the home. There is a need to keep written records relating to the management of the service user’s finances. 44 Monks Close I55 s62976 44 Monks Close v243514 AN 271005(4).doc Version 1.40 Page 10 EVIDENCE: The proprietor does not keep any written records relating to the care that the service user receives. Although this does not currently cause obvious difficulties there is a need to keep some records so that information is recorded, particularly with regard to health issues, and can be referred to in the future if needed. It is required that a weekly diary is kept for the service user which particularly records issues relating to health needs and activities. The Proprietor gave examples of how risks are assessed prior to any decisions taken about the service user’s life. There are no written records of this taking place. It is required that written risk assessments are carried out for situations that present risks to the service user. The service user lives as part of the family and is involved in discussions about issues that affect the family and the running of the household. The needs of the service user are considered in all aspects of the home. The Proprietor is responsible for looking after the service user’s finances and is currently trying to open a bank account for the service user. It is required that written records are kept relating to the receipt and expenditure of the service user’s money. 44 Monks Close I55 s62976 44 Monks Close v243514 AN 271005(4).doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 15, 16 and 17 The service user is encouraged to maintain and develop their social and communication skills. The service user is supported by the Proprietor to take part in social activities within the community, however, this can be difficult due to the lack of public transport available in the local area. The service user is supported to maintain contact with family and friends. The service user’s rights are respected. The service user said that she enjoys the meals and that the Proprietor knows what she likes. 44 Monks Close I55 s62976 44 Monks Close v243514 AN 271005(4).doc Version 1.40 Page 12 EVIDENCE: The service user has difficulties with verbal communication and can be difficult to understand at times. However, the Proprietor encourages her to communicate and to make her own choices. The Proprietor has recently moved from another county and is having difficulty in obtaining support from social services with regard to the provision of meaningful day services for the client. Therefore, currently the Proprietor has to provide support to the client to access any leisure and social activities. The Proprietor does not have a car and there is limited public transport in the area in which they live. The Proprietors daughter can provide transport occasionally. The service user told the Inspector that she likes to go swimming but that this does not take place at the moment. She said that she also likes to go shopping and on holiday. The Proprietor and the service user go abroad on holiday several times a year and the service user spoke very positively about these trips and the friends that she has there. Considering the limitations due to transport difficulties the Proprietor does make a lot of effort to ensure that the service user is not isolated and can go out to the wider community. The Proprietor and the service user return to their original county approximately twice a year so that the service user can have contact with her family. The service user was having lunch when the Inspector arrived and this looked appetising and healthy. The service user told the Inspector that the Proprietor makes nice meals and knows what she likes. The service user has some physical difficulties which means that her involvement in the preparation of meals is limited. However, she is involved in other household tasks, such as tidying her bedroom. 44 Monks Close I55 s62976 44 Monks Close v243514 AN 271005(4).doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20 The service user receives support in the way that she prefers. There is a need to keep records relating to the health needs of the service user, including records relating to the administration of medication. EVIDENCE: The Proprietor knows the service user very well as she has lived with the family for over fifteen years. The Proprietor provides any personal care support required by the service user. The Proprietor described recent events with regard to the physical health of the service user and of the appropriate action that she took at that time. The service user is registered with the local GP practice. A requirement has already been made in this report about the need to keep records relating to the health needs of the service user. The Proprietor is responsible for the storage and administration of medication to the service user. It is required that records are kept of the administration of medication and that the medication is stored securely. 44 Monks Close I55 s62976 44 Monks Close v243514 AN 271005(4).doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The service user feels that her views are listened to. There is need for the Proprietor to undertake training with regard to the protection of vulnerable adults. EVIDENCE: The home does not have a formal complaints procedure and the service user would find this difficult to use. The service user told the Inspector that the Proprietor listens to her and sorts things out for her. The service user has little contact with anyone other than the family and so may find it difficult to raise any complaints that she may have about the service provided. The Proprietor feels that the service user is part of her family and that she offers protection as such. The Proprietor is aware of the service user’s needs and the risks attached to her lack of understanding of situations. It is required that the Proprietor attends training with regard to the protection of vulnerable adults. 44 Monks Close I55 s62976 44 Monks Close v243514 AN 271005(4).doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30 The parts of the home seen by the Inspector are homely, comfortable and clean. EVIDENCE: The Inspector saw the communal areas of the home and the service user showed the Inspector her bedroom. The home is situated on an isolated housing estate which has little public transport. The home is comfortably furnished and the service user’s room has lots of her personal items around. The service user has a budgerigar and the family have a very large dog. 44 Monks Close I55 s62976 44 Monks Close v243514 AN 271005(4).doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 The home does not employ any staff. EVIDENCE: The Proprietor is the main carer for the service user. The Proprietors daughter does provide support to the service user on occasions. It is required that the Proprietor obtains a CRB disclosure for her daughter as she does provide care to the service user. 44 Monks Close I55 s62976 44 Monks Close v243514 AN 271005(4).doc Version 1.40 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 and 42 The Proprietor has provided care for the service user for over fifteen years and is competent to do so. The home does not have a formal quality assurance process but the service user is involved in decisions affecting her. The Proprietor has taken steps to protect the health and safety of the service user. 44 Monks Close I55 s62976 44 Monks Close v243514 AN 271005(4).doc Version 1.40 Page 18 EVIDENCE: The Proprietor was previously a foster carer and has provided care to the service user since the service user was a child. The Proprietor does not have any formal qualifications and it is recommended that she undertakes NVQ Level 3. The home does not have a formal quality assurance process but the service user is involved in discussions affecting her and the rest of the household. The Proprietor has taken steps to protect the health and safety of the service user. For example, there are smoke detectors and a carbon monoxide detector around the home. It is recommended that an additional smoke detector is placed at the top of the stairs. It is required that the Proprietor undertake training with regard to Food Hygiene and First Aid. The service user does not require any specialist equipment but handrails have been put up on the staircase. 44 Monks Close I55 s62976 44 Monks Close v243514 AN 271005(4).doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 1 x x x x Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 1 2 3 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 2 2 2 x 2 3 3 Standard No 31 32 33 34 35 36 Score x x x x 1 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 44 Monks Close Score 3 2 1 x Standard No 37 38 39 40 41 42 43 Score x x 1 x x 2 x I55 s62976 44 Monks Close v243514 AN 271005(4).doc Version 1.40 Page 20 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 15 Requirement The registered person must keep a weekly diary for the service user, particularly recording issues relating to her health and activities. The registered person must keep records relating to the receipt and expenditure of the service users money The registered person must keep written risk assessments for issues that pose a risk to the service user. The registered person must keep records relating to the receipt and administration of medication The registered person must attend training with regard to the protection of vulnerable adults The registered person must attend training with regard to Food Hygiene and First Aid The registered person must obtain a CRB disclosure for all people providing care to the client Timescale for action 30th nov 2005 2. 2 17 (2) 30th Nov 2005 31st Dec 2005 30th Nov 2005 31st January 2005 31st January 2005 31st January 2005 3. 3 13 (4) 4. 5. 4 5 13 (2) 13 (6) 6. 7. 6 23 10 (2) 19 44 Monks Close I55 s62976 44 Monks Close v243514 AN 271005(4).doc Version 1.40 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 37 42 Good Practice Recommendations it is recommended that the Proprietor undertakes NVQ Level 3 training It is recommended that a smoke detector is placed at the top of the stairs. 44 Monks Close I55 s62976 44 Monks Close v243514 AN 271005(4).doc Version 1.40 Page 22 Commission for Social Care Inspection 3rd Floor Cavell House St Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 44 Monks Close I55 s62976 44 Monks Close v243514 AN 271005(4).doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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